Longitudinal changes in cardiac function in the very elderly: the Jerusalem longitudinal cohort study  

作　　者：David Leibowitz Irit Stessman-Lande Hend Sliman Jeremy M Jacobs Jochanan Stessman Dan Gilon 

机构地区：[1]Jerusalem Institute of Aging Research,Hadassah-Hebrew University Medical Center,Mount-Scopus,Jerusalem,Israel [2]Coronary Care Unit,Hadassah–Hebrew University Medical Center,Mount-Scopus,Jerusalem,Israel [3]Department of Geriatrics and Rehabilitation,Hadassah-Hebrew University Medical Center,Mount-Scopus,Jerusalem,Israel

出　　处：《Journal of Geriatric Cardiology》2019年第11期800-805,共6页老年心脏病学杂志（英文版）

摘　　要：Background People over the age of 85 are a rapidly growing age group with a high incidence of congestive heart failure(CHF),in particular heart failure with preserved ejection fraction(HFp EF).The diagnosis of CHF is challenging and longitudinal data assessing cardiac structure and function are necessary to distinguish physiologic from pathologic cardiac aging.The objective of the study was to determine longitudinal changes in cardiac struture and function from ages 85 to 94 years using home echocardiography.Methods Subjects were recruited from the Jerusalem Longitudinal Cohort Study.Sixty three members of the initial cohort(32 F,31 M)who underwent home echocardiography at age 85 were the subjects of the current study and underwent repeat home 2-D and Doppler echocardiographic assessment at age 94.Results There were no significant longitudinal changes in left ventricular mass index(LVMI),however LV end-diastolic volume significantly decreased from 113.4±30 to 103.6±35.5 m L(P<0.02).Ejection fraction(EF)remained stable,however longitudinal systolic function significantly decreased with age from 7.9±1.8 to 6.6±1.4 cm/s2(P<0.0001).Diastolic function as assessed by increased E:e’(11.2±3.4 to 16±7.5,P<0.0001)and increased left atrial volume index(34.1±11.3 to 42.4±13.7 m L/m^2,P<0.0001)was reduced with aging.Conclusions This study demonstrated preserved EF with decreased longitudinal systolic function and diastolic function without significant change in LV mass.Changes in LV function in the very elderly may be independent of changes in LV geometry.Background People over the age of 85 are a rapidly growing age group with a high incidence of congestive heart failure(CHF), in particular heart failure with preserved ejection fraction(HFp EF). The diagnosis of CHF is challenging and longitudinal data assessing cardiac structure and function are necessary to distinguish physiologic from pathologic cardiac aging. The objective of the study was to determine longitudinal changes in cardiac struture and function from ages 85 to 94 years using home echocardiography. Methods Subjects were recruited from the Jerusalem Longitudinal Cohort Study. Sixty three members of the initial cohort(32 F, 31 M) who underwent home echocardiography at age 85 were the subjects of the current study and underwent repeat home 2-D and Doppler echocardiographic assessment at age 94. Results There were no significant longitudinal changes in left ventricular mass index(LVMI), however LV end-diastolic volume significantly decreased from 113.4 ± 30 to 103.6 ± 35.5 m L(P < 0.02). Ejection fraction(EF) remained stable, however longitudinal systolic function significantly decreased with age from 7.9 ± 1.8 to 6.6 ± 1.4 cm/s2(P < 0.0001). Diastolic function as assessed by increased E: e’(11.2 ± 3.4 to 16 ± 7.5, P < 0.0001) and increased left atrial volume index(34.1 ± 11.3 to 42.4 ± 13.7 m L/m^2, P < 0.0001) was reduced with aging. Conclusions This study demonstrated preserved EF with decreased longitudinal systolic function and diastolic function without significant change in LV mass. Changes in LV function in the very elderly may be independent of changes in LV geometry.

关 键 词：ECHOCARDIOGRAPHY The ELDERLY VENTRICULAR FUNCTION 

分 类 号：X70[环境科学与工程—环境工程]